Known medically under the name decryptorchidism. The testicles are male sexual organs responsible for the production of both sperm and certain hormones, which are generally formed in the abdomen during fetal development, until they descend into the scrotum.
When a baby grows in its mother's womb, testicles form in the abdomen. In fact, it is not until the last two months of pregnancy, when the testicles descend to the scrotum.
However, when one or both testicles remain in the abdomen, it is a medical condition that is also called undescended testicle. It is estimated that it affects three percent of children.
Although at the beginning, especially at the time of diagnosis (which is usually common when the specialist performs the first evaluations of the newborn), it usually alarms parents, it generally tends to resolve on its own within the first months of the baby's life.
However, only in some cases it may be necessary to perform surgery in order to solve the problem.
What are the causes of an undescended testicle?
Until now, the exact or precise cause that causes a testicle not to descend into the scrotum, remaining trapped in the abdomen, is unknown. It seems that excess fibrous tissue, or the muscles themselves not stretching in the groin, can cause it. But they are not the only reasons.
In fact, some researchers believe that, in reality, it is a combination of certain factors, including genetics, the mother's health and, finally, some environmental factors, such as tobacco (particularly if the mother has been a passive smoker during pregnancy), or exposure to pesticides.
Premature birth is also considered a major risk for an undescended testicle. In fact, it is estimated that about a third of premature babies have it.
What to do after diagnosis?
Once the specialist, during the examination of the newborn, has found only one testicle in the scrotum (instead of two, or even none), he or she will most likely refer the child to a specialist.
This specialist, usually a pediatric urologist, may take a wait-and-see approach, since the undescended testicle often reaches the right place on its own 3 to 6 months after birth.
Your doctor may also order an ultrasound, MRI, or CT scan to determine where exactly the testicle is located. However, in most cases these tests are not truly necessary.
How is it treated?
As we mentioned in the previous section, the undescended testicle usually resolves on its own before the baby is 6 months old. At that time, the doctor may perform a new physical examination, and even perform certain tests if the testicle has not yet descended.
Regarding treatment, it is true that hormones that stimulate the production of testosterone can be used to help the baby's testicle descend, which would involve injecting a hormone known as human chorionic gonadotropin (hCG).
According to research published in the journal American Family Physician, this method will have a success rate of around 20 percent. Although it can potentially lead to early puberty, so it is not considered very safe.
Will surgery be necessary?
When the testicle has not finally descended before one year of age, the child may need a surgery known as orchiopexy, which is usually performed as an outpatient procedure in which the surgeon makes a small incision in the groin to allow the testicle to descend to a much more suitable position. Recovery generally takes about a week.
If the presence of extra tissue is the cause of the testicle not descending, the surgeon may remove it. In other cases, however, all that has to be done is to stretch the ligament that contains the testicle, which will also help the testicle to descend to a normal position.
Only in some specific cases does the testicle contain abnormal, non-viable tissue, or is poorly developed. If so, the surgeon will remove it completely.
Can it affect fertility?
Indeed, cryptorchidism can affect fertility when left untreated. The main reason is found in the high temperature that usually exists inside the body, which can affect the normal development of the testicles and the production of sperm.
However, it is true that men with two undescended testicles tend to experience more fertility-related problems compared to men who only have a single undescended testicle.
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